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15D2143485 CLIA NUMBER - PAYLESS PHARMACY #21-336

Laboratory Demographics

CLIA Number: 15D2143485

Facility Name: PAYLESS PHARMACY #21-336

Facility Address:
1500 W MCGALLIARD RD
MUNCIE, IN
ZIP 47304
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Facility Phone Number: 765 741-1494

Facility Type: Other - PHARMACY

Certificate Type: Waiver
NPI Number: 1255845871

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 15D2143485
LAB Type Other - PHARMACY
Facility Name PAYLESS PHARMACY #21-336
Street 1500 W MCGALLIARD RD
City MUNCIE
State IN
ZIP 47304
Phone 765 741-1494
CertificateType 4
CertificateEffectiveDate 1/31/2024
CertificateExpirationDate 1/30/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024